Off They Go

12:30 Good Friday.
Dressed, in hallway, in wheelchair. 

Roger, the physical therapist appears and we all greet.  "Hey Bernie, you're in your chair!" Roger pops up, "Yeah, he got here all by himself."  On Roger's command Bernie steps up into the walker and off they go.

He got out of his wheelchair without objection, and I was surprised that he didn't struggle to his feet.  He wasn't spry by any means, but he was able to stand, then walk directly and without shuffling.

They circle the entire floor and Roger offers, "Want to sit here with Mike for a couple of minutes?"  So Bernie sits.

A glass of water later Roger reappears to take another lap.






They return and Bernie asks to get back on the bed.

Kathleen had stopped at Nazareth House and collected the mail, and a couple of rosaries.  She reads Bernie a few cards, and he asks her to make a polite reply.

I had made a list of email correspondents Bernie had been in touch with when he was emailing.  I ask if it is OK to send them an invitation to this blog, and we go over about a hundred names. He is quick to recognize each name and include those he thought would like to hear about his status. 

While on the bed he continued to turn from side to side without prompting.  Kathleen encouraged him and they both reiterated he would like to get back to Nazareth House as soon as possible.

We'll monitor it

7:15pm
Eyes closed, street clothes, under covers.

I drop by and find Bernie, turning on his side.  This is unusual so I just watch for a minute or two. He turns on the other side.

Hey, he got the memo!

I say Hi and he is immediately alert. We chat for a minute and he grimaces.  "You ok Bernie?"
 "It hurts when I turn over." "What hurts?" "The catheter."

I find the nurse and explain, "Earlier today I got a call from the afternoon nurse saying Bernie complained about irritation from the catheter.  She said she'd have the Doctor examine him.  I asked her if we could get a Urologist  to look at him."  The evening nurse said he'd check the records.

He comes back and says he sees the note, and that the Doctor said he'd like to monitor the situation before calling a Urologist.  The nurse said he was unaware Bernie was experiencing pain so he'd check him.

A few minutes later he reports that Bernie feels pain whenever he changes position -- turns from his left side to his right side. 

The very thing he should be doing to heal his bottom is now causing pain with the catheter.

We'll monitor it.

Play Some Cads?

Monday, 2pm
Bernie in bed, shoes off, no covers, asleep.

Kathleen says Hi and Bernie is immediately back to life.  "How are things?" "Not too bad," says Bernie.  A few pleasantries follow.

Bernie's eye continues to improve and his forehead remains flake free.

We find him with pillows supporting one side of his bottom and legs.  The bed is a special kind of hospital bed, an air mattress which has cells on the left and right sides.  The air pumps to pressurize the left side, then the right.  The purpose is to heal the sore on his bottom.  His using pillows and shifting his weight is a help.

He complains about the catheter causing pain.

While Kathleen is checking with the nurse to see if zinc is part of the normal routine, a silence ensues.  I ask Bernie.  "Did you ever play cards?"  "No." "Even in the seminary?" "No, but the Irish played cards all the time.  Do ya wanna play some cads" He says assuming an strong Irish dialect, and his familiar elfish twinkle.

"Did you play any games in seminary?"  "No." "What did you do for fun, then?"  Then comes a stuttering "Oh dear God, Oh dear God...."  He can't remember something and it drives him crazy.

From a lighting fast set of responses to suddenly something is derailed and he gets frustrated -- the words don't come.

The aide arrives to take Bernie to occupational therapy. We make our farewells.

On the way home Kathleen calls Alice from Nazareth House to report in.  Alice suggests we arrange a urologist to visit to see if the catheter is still needed.  She agrees to do so Monday afternoon.

A Fresh Shower and a Fresh Attitude.

Kathleen and I drop in about 9:15 Sunday.  Bernie looks the best I've seen him in weeks.  His forehead isn't flaky, his right eye is better, if still only about 90%.  He is responsive and even bright in conversation.

"Walkie Walkie?"  "No, thanks."  Alas.

"How bout a ride in the chair?"  "No, thanks." Alas.

"How bout we just push this bed up and down the hall?"  He smiles.  That's what I needed.

Kathleen reviews papal events, Palm Sunday gospels and I read the Dagwood comic from the Chronicle.  It brings a spontaneous smile.  This is new.

Usually we have to pester him to drink his Ensure (nutrition supplement drink), but today he said he likes the chocolate and opened up and sipped on the bottle which had been resting on his night table.

He has the choice of apple and cranberry juice, and often drinks from the always cold glass of water.

He does not initiate any conversations, but Kathleen keeps him engaged, and reiterates at least five times that Nazareth House wants him back soon, and the road home requires walking and alternating sides while he is in bed.

I double check and see that he is on the list to receive communion, but we leave before the Eucharistic  Ministers (or Priest this week?) arrive. 

"See you tomorrow Bernie."  "That will be good."

Better in the Morning?

11am:
Sleeping, mouth agape, no shoes on bed.

It takes about two minutes for him to get aroused enough to engage in conversation. I sternly suggest a walk.  "If you don't walk you won't get strong enough to get back home." "Oh, OK." "Let me find out the best way to take you for a walk."

I find the nurse who then asks the Physical Therapist if Bernie is able to walk.  After a brief discussion we decide a wheel chair ride is the best.

We go "Fred Flintstone" style -- feet used as propulsion.  A bit of gentle steering gets us to the back garden.

Bernie asks the time.


I point to his watch, and he stares and says, "A little after four?" "Look again Bernie."  15 seconds of staring and he says "Oh, nearly 11:30?" "Yeah, good."

We sit in the quit and hear the birds.  Bernie does not sustain a conversation and does not begin one. 
It does feel good to absorb some filtered sun.  A little after noon the nurse finds us and asks if Father would like his lunch outside or in his room.  "I think in my room." Bernie says.  He needs a push back and I leave him in his chair as he begins his lunch.

Sleepy

3pm Sound asleep on bed with shoes off.

I sit and wait for him to stir, and after maybe 10 minutes he comes around.  "Hi Bernie."
"Hi."

He can't sustain a conversation and drops back to sleep.  In a bit he rouses.

I offer a walk and he objects and drifts off again.

I offer him his watch and he puts it on then says, "Can I have a paper and pen, I want to send you something."  He then proceeds to write my address and assures me that he will send something.

He drifts off again. A little later he asks if I have an envelope and stamp.  "No, but I'll post whatever you wish." "Ok, then." And gone again. 

He may have been drifting in and out of a dream, but he was not alert nor saw any reason to be.

The physical therapist arrives for the scheduled work and Bernie tries to talk his way out of therapy, to no avail.  "See you tomorrow Bernie," I say.  He offers a firm and sure handshake.

Three Social Workers

Wednesday
Kathleen arrives Wednesday afternoon to find the Smith Ranch social worker speaking with Mary Schembre.  The three confer about Bernie's status and plan.  All agree walking is key and get Bernie to take a walk.  After a visit Kathleen gets Bernie to take a second walk.  If this could continue.

Better to be angry?

As I come to learn about depression I discover it is far more complex and varying than I imagined.  And it is a moving target.  For the past week I've been concerned about Bernie's slow moving, sleepy, "out of it" disposition.  He moves slowly, speaks softly, is withdrawn.

Fragrant Beef Stew, Fresh Green Beans with Herbs, Rice, Fresh Fruit Cup, Broth, Apple Juice, Milk

Today I arrive about 5pm and see his hot (and deliciously fragrant) dinner pushed away from him as he sits upon his bed.  He is in street clothes with his shoes on with no blanket. When I arrived he has his eyes closed, and I think to myself "this is very familiar." Bernie hears me approach and says hello.  I ask if he'd like his dinner table brought a little closer and he becomes agitated and says "I don't want anything to do with it."

Oooh.

I haven't seen him have this much energy in weeks.

"Is something wrong with dinner?"  "No. I don't want it."  "Would you like something else?" "No."

I pause for a bit.

"Bernie you seem a little angry, is everything ok? Can I do anything?" "Not a damned thing."

After a bit of silence I see that he has not filled out tomorrow's menu choices. "Would you like a hand with the menu?" "No. I don't want anything to do with it."

Another brief pause.

"Bernie, is there anything in particular upsetting you?" "It's this damned depression." "Boy, I can understand that," I say. "Good."

Bernie anxiously glances at the clock every five minutes.  "I see you looking at the clock, is there something you're concerned about. Is there anything you are waiting for." "No."

Hmmmm.

He reaches for the apple juice on his tray with directness. He take a small sip and immediately replaces it on the tray, then goes silent for two minutes.  Then he repeats with the same determination. Then slient with eyes closed. And again. "Things ok Bernie?" "Fine."

I have become aware that depression and anger can be self-feeding and interrelated. I am not privy to his medication, but last week at the hospital I asked the nurse about antidepressants. She said, "Sometimes the doctor will discontinue antidepressants because they cause drowsiness.  They are re-instituted once patients stabilize."

I know the medications take some time before building sufficiently in the system, and I'm guessing the same is true in reverse.

I can't tell if two are related, but Bernie's disposition today was not his usual.

Cliff reports

I let Cliff know about the blog and he reports:
 
Betty and I visited on Thursday, March 14th. He was concerned at that time about having some ministers or priest visit him -- this is a very important part of his life.

Eyes wide shut

At 9am Sunday Bernie was in bed in night clothes, but was very responsive and alert when he heard me come in.  He opens his eyes, but the right eye never quite opens fully.  This has received attention in the past, and I'll follow up more Monday.

When not in conversation he closes his eyes, but this morning he opened up and was quite responsive.  Shortly the aide appeared and said he'd help Bernie change into street clothes, with a green shirt for St. Patrick's Day.  In a few minutes, I checked and he was being wheeled back from the bathroom with brushed teeth.  I asked that he stay in the chair so we could go exploring.

The sun was streaming into the dining room and we turned on the CD player for some classical music.  Soon it became too warm and Bernie asked for some relief.  We found some shade but maintained the green Marin County views.

We explored the 2nd floor and found "The Birder Room," officially the Marin Lounge, a spacious community room with easy chairs and tables.  Birder Room because there were three field guides to birds, a recent list of over 30 species spotted, and field glasses.  I handed the Bernie the field glasses (backwards) and after a joke about seeming like a Three Stooges routine, he said, "Here take these, I have no use for them."

A little further on we found a similar room, the Library which we found was the site where the visiting Priest offered Sunday Communion.  We returned to Bernie's room and, for the last 20 feet I challenged him to wheel himself.  He did well, negotiated a tight corner into the room, and then he asked to be wheeled the last 5 feet.

At the appointed time I was in the Library to ask the Priest to visit Bernie, but to find instead a Husband and Wife team of Eucharistic Ministers from Church of St. Isabella in San Rafael. They noted Bernie on the list of patients and, a few minutes later came to his room, said the Our Father together, read today's Gospel, and offered communion. It was another positive experience at Smith Ranch (which they themselves call Kindred Transitional Care and Rehabilitation).

Later I read the staff list from the the church bulletin that was left behind, and Bernie said, "Deacon Jerry Friedman?  He comes to Nazareth House."  The contrast from the insomnulescent Bernie to him being aware and responsive is startling.  Seemingly out of it to with it in less than a second.

Bernie at 3

Dropped in at about 3pm to find Bernie, dressed in street clothes, sleeping under the covers.

Noticed the pink schedule card for today so decided to wait a bit.  I'm guessing that next to it are the results of the speech therapy.  I admit I'm puzzled to offer a "U" or "X". On his bed stand was today's untouched SF Chronicle. It will be tempting to drop by Sunday at lunch time.

After about a half-hour at Physical Therapy Bernie returns, is helped into bed and immediately dozes off.  His head drooping back with his mouth open it is 3 or 4 minutes before he stirs slightly.  He asks for the sheet to select the weekend meal choices that the PT referred him to.

"Oh Dear God," punctuates his slow struggle with a sandwich or soup & salad choices.  Admittedly there are many choices but it is hard work to get through the selections.

I ask about the Physical Therapy, and he describes twirling a broomstick but dozes off mid sentence, then returns about 30 seconds later. His breath is shallow and frequent as he dozes.

He is cordial but subdued as I say I'll see him tomorrow.

Mexico in November?

Wednesday, March 13th. 
Kathleen arrived to find Bernie lying in bed with his eyes closed.  After some effort he finally engaged her and had a brief conversation.

Among the subjects was Kathleen's question, "Would you like to visit Mexico again?"  Bernie was very positive with the prospect and proposed specific dates in November, 2013.  The goal is to have a goal. Such a trip would require him to be in good walking condition, and November is a realistic time, provided he makes daily progress.

By the way, he has a direct telephone line at Smith Ranch: 415-446-3955.  Alas, he's probably in bed so you should have no trouble catching him.

Two steps forward...

You may recognize the outfit Bernie is wearing.  It's the same as yesterday. At bedtime he wouldn't let the nurses help him change into a night gown. 

At our visit today, when Kathleen told Bernie that Alice from Nazareth House said, "We want him back -- and soon -- maybe next week."  Bernie got very excited and said, "Isn't that good."  The staff at Smith Ranch wasn't so optimistic. They said we have to get the sore on his bottom healed. And he has to be able to be able to get out of bed and walk on his own.

Yesterday, during the intake assessment, Bernie resisted letting the nurses look at the sore on his bottom.  But he later relented and it is being treated.





And the catheter which was removed before he left the hospital is now back.

Late in the afternoon Tuesday the Occupational Therapist was doing an evaluation and it tired Bernie.  He was eager to take a nap as we left.

I promised Bernie we'd go to Eric's Restaurant on Church (one of his favorites) when he is discharged from Smith Ranch and returns to Nazareth. This seemed to brighten his attitude.

Check in at Smith Ranch

After a stop for ice cream Bernie checks in to Smith Ranch. This seems like a high energy site where their focus is encouraging patients to get their strength back.  Everyone seemed VERY positive and persuasive.  Mike altered them of Bernie's predisposition to lie in bed, but the staff said they were very familiar with this and they would get him out and walking and reinforcing his engagement with others, and building his strength.

Yesterday, Monday, they did an intake assessment and today have activities planned.

Here's Bernie being weighed in:

Off to Physical Therapy at Smith Ranch Care

Monday, March 11th

A urinary blockage and bed sores required a move from Nazareth House about two weeks ago, first to Novato Community Care, and then as an infection took hold, to Novato Community Hospital where Bernie has been for over a week.  He is on the mend and is taking the recommendation of doctors and is off to a physical rehab facility in San Raphael, Smith Ranch Care Center.  His stay at the hospital has been mostly in bed and some frequent physical therapy to improve his strength is the goal.  He is anticipated to return to Nazareth sometime soon.

I'll pick up Bernie this afternoon and take him to Smith Ranch by car.

Introduction

How do we keep Fr. Bernie's friends updated as his situation changes, day-to-day?  How about a blog.  And here we are. I write this on his behalf.

Kathleen and I (Mike Young) were married by Bernie twenty something years ago, and have been close ever since. We see him often, and thought this update might be useful to his many friends.


As you may know, he moved from his long time Gough Street apartment in San Francisco in the Spring of 2011, first to a temporary stay at Coventry House (Now Vintage Coventry) and finally in the Summer of 2011 to Nazareth House in San Rafael.

Depending on his attitude when he is at Nazareth House he may take either cell (415-335-0593) or landline calls (415-479-2627) calls using the Main Nazareth Number (415) 479-8282, and ask for Father Brennan in the Special Care Unit. He reads all cards and letters.

You may send your prayers and cards to him:

Fr. Bernard Brennan

Nazareth House

245 Nova Albion Way, Suite C-19

San Rafael, CA 94903